[Preoperative mortality of heart surgery patients]

Cardiac surgery is principally joined to mortality at or because of waiting lists. In a retrospective study patients of either sex were analyzed, who died preoperatively during period A (1980-1984) or during period B (1988-1992). During A 100 patients died while during B 136 died, although the total numbers of open heart procedures were similar during both periods. Demographic data show that during B more patients with CHD died than during A. In both periods most of the patients could be assigned to NYHA/CCC classes III (71% (A) vs 64% (B)). Mean age increased from 55.7 to 62.8 years being the only significant parameter to differ (p < 0.001). The portion of urgent operations increased to 53.7% during B. The analysis of time intervals demonstrates that the interval from invasive diagnosis until announcement for operation and the interval from announcement until death were significantly shortened (p > 0.02). The increasing age and progredient morbidity may be responsible for this phenomenon. Preoperative mortality increased significantly from 2.0% (A) to 2.7% (B) in the total group, as well as in the subgroups. For patients with CHD the mean mortality was 2.3% and for patients with aortic valve disease it was 4.3% during B. The analysis of morbidity and mortality of patients dying at the waiting list is strongly required, since mortality rates of the total and the subgroups are unexpectedly high and not acceptable.